Active NPI
USA Bunnag, DDS.,PA
- General Practice Dentistry
- Bethesda, MD
National Provider Identifier
1124493655
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 11494
- Legal business name
- USA BUNNAG, DDS.,PA
- Practice address
- 6501 Democracy Blvd
Bethesda, MD 20817-1685 - Phone
- (301) 896-0633
- Fax
- (301) 896-0633
- NPI assigned
- Dec 9, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. USA Bunnag, DDS
- Title
- President
- Phone
- (301) 896-0633
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 11494 | MD | Primary |
Addresses
Primary practice location
6501 Democracy Blvd
Bethesda, MD 20817-1685
Mailing address
6501 Democracy Blvd
Bethesda, MD 20817-1685
Phone (301) 896-0633
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 699949200 | Medicaid | MD |
Other names 1
- Bunnag Comprehensive Dentistry
National Provider Directory
National Provider DirectoryLocations
6501 Democracy Blvd
Bethesda, MD 20817
Phone (301) 896-0633
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Dentist
- Towson, MD
- NPI 1437993664
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1449619200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1449619200000",
"number": "1124493655",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6501 DEMOCRACY BLVD",
"city": "BETHESDA",
"state": "MD",
"postal_code": "208171685",
"telephone_number": "301-896-0633",
"fax_number": "301-896-0633"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6501 DEMOCRACY BLVD",
"city": "BETHESDA",
"state": "MD",
"postal_code": "208171685",
"telephone_number": "301-896-0633",
"fax_number": "301-896-0633"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "USA BUNNAG, DDS.,PA",
"organizational_subpart": "NO",
"enumeration_date": "2015-12-09",
"last_updated": "2015-12-09",
"status": "A",
"authorized_official_last_name": "BUNNAG",
"authorized_official_first_name": "USA",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "301-896-0633",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": "MD",
"license": "11494",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "699949200",
"state": "MD"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Bunnag Comprehensive Dentistry",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Bethesda, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.